Fillable SOUTH DAKOTA COSMETOLOGY COMMISSION (South Dakota DLR)

Fill Online, Printable, Fillable, Blank SOUTH DAKOTA COSMETOLOGY COMMISSION (South Dakota DLR) Form

Use Fill to complete blank online SOUTH DAKOTA DLR pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

SOUTH DAKOTA COSMETOLOGY COMMISSION (South Dakota DLR)

On average this form takes 13 minutes to complete

The SOUTH DAKOTA COSMETOLOGY COMMISSION (South Dakota DLR) form is 2 pages long and contains:

  • 0 signatures
  • 10 check-boxes
  • 47 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your DLR forms online.

South Dakota Department of Labor & Regulation (DLRA) aim to promote economic opportunity and financial security in the South Dakota. They support individuals and businesses through expert services, employment solutions and business practices.

BROWSE SOUTH DAKOTA DLR FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
DLR COSMETOLOGY RECIPROCITY APPLICATION FOR LICENSE TO PRACTICE IN SOUTH DAKOTA & CHECKLIST Rev. 04/2020
SOUTH DAKOTA DEPARTMENT OF LABOR AND REGULATION
SOUTH DAKOTA COSMETOLOGY COMMISSION
500 E Capitol Ave, Pierre, SD 57501 | Tel: 605.773.6193 | Fax: 605.773.7175 | cosmetology.sd.gov
RECIPROCITY APPLICATION FOR LICENSE TO PRACTICE IN SOUTH DAKOTA
PLEASE PRINT. Applicant is required to answer all questions. Read and follow the directions on the checklist (see reverse side).
$100.00 FEE IS NON-REFUNDABLE. Money order or cashier’s check acceptable. No personal checks accepted for reciprocity.
1. PERSONAL INFORMATION – Print clearly
Name: ______________________________________________________ Social
Security Number:___________________________
Address: __________________________________________________ _____________________________ _____ ___________
STREET CITY STATE ZIP
Telephone: (home) _______________________ (cell)_______________________ Date of Birth: __________________
Email address (if you have one):________________________________________________________________
2. CURRENT AND PRIOR LICENSING (must have a current license from another state board or country You must request a
certification of licensure from the most recent state in which you are licensed. Please note that a copy of your license is NOT a
certification — see Item #2 on the attached reciprocity checklist).
Current Valid License Number:__________________________ in the State of:___________________ Expiration Date:___________
Type of license (check only one): Cosmetology Esthetician Nail Technician
(Only license for license is accepted, there is no crossover allowed.)
List any other states/countries where you hold license(s) OR have held a license:___________________________________________
Have you ever had your license(s) suspended or revoked? Yes No If yes, why:______________________________________
Is your spouse an active member of the armed forces? Yes No If yes, send a copy of your military ID card and the reciprocity and
temporary license fee will be waived. Future year renewal fees will also be waived
Have you ever been convicted of, plead guilty or nolo contendere to a felony or any state or federal crime relating to narcotic drugs?
☐ Yes No If answered “yes” explain on a separate sheet giving date, place a
nd full particulars and attach as part of
this application.
3. TESTING Applicants must have passed a theory examination. A certification is needed from the other state board showing
testing information.
Indicate your language preference for the examinations: English Vietnamese
Do you need reasonable testing accommodations due to a disability? Yes No
4. EDUCATION (Education: 1,500 Cosmetology, 600 Esthetics, 400 Nail Technician OR a combination with work credit)
Cosmetology School Attended:_____________________________________ City:_________________________ State:_______
Date Started at School:_____________ Completion Date:______________ Total Hours Completed:________________
Were any education hours earned in a foreign country? Yes No (If yes, additional rules apply.)
High School Attended or GED:_________________________________________ City:______________________ State:______
Graduation Date or GED Date: ____________ Your name in high school or when tested:________________________________
5. WORK EXPERIENCE (complete & attach the work experience affidavit if you do not meet the required education hours)
I declare and affirm under the penalties of perjury that this information has been examined by me and to the best of my knowledge and
belief, is, in all things true and correct. If granted a license to practice Cosmetology, Esthetics, or Nail Technology in the State of South
Dakota, I promise to abide by all the laws of the State of South Dakota governing these practices.
Signature of Applicant:_____________________________________________________________ Date: _____/______/_______
(OVER FOR ADDITIONAL INFORMATION)
DLR COSMETOLOGY RECIPROCITY APPLICATION FOR LICENSE TO PRACTICE IN SOUTH DAKOTA & CHECKLIST Rev. 04/2020
SOUTH DAKOTA COSMETOLOGY COMMISSION
Tel: 605.773.6193 | Fax: 605.773.7175 | email: cosmetology@state.sd.us
CHECKLIST TO COMPLETE THE RECIPROCITY REQUIREMENTS (AS 4/1/2020)
You must submit the following for reciprocity. Documentation must be submitted in English only. Incomplete submissions are
held for only three months. Fees are non-refundable.
☐ 1. RECIPROCITY APPLICATION. Complete all areas and sign. Attach the following:
☐ Copy of birth certificate, naturalization certificate, permanent resident card, U.S. passport or driver’s license
☐ Copy of high school graduation diploma or transcript, GED certificate*
☐ Current photograph or copy of photo ID. (must be a clear photo)
* If your high school diploma was earned in another country, you must have your license translated by an official translation
service and mail a copy of the translation and a copy of the original diploma with your application.
☐ 2. CURRENT AND PRIOR LICENSING. A CURRENT LICENSE FROM ANOTHER STATE OR COUNTRY IS REQUIRED FOR
RECIPROCITY and is proven by a CERTIFICATION FROM A STATE OR GOVERNMENT COSMETOLOGY BOARD. A certification of
a current licensure must be mailed directly from that State Board or Country licensing agency to this State Board office.
**IMPORTANT** CERTIFICATIONS can take time to obtain so call and get this process started immediately. Please note a
copy of your license is NOT a certification. If you have a license or have held a license from another country you need to
contact t
he Commission Office for the “Foreign Applicant” information. Only license for license is accepted, there is no
crossover.
☐ 3. TESTING. THE SOUTH DAKOTA STATE LAWS/RULES EXAM IS REQUIRED OF ALL THOSE REQUESTING RECIPROCITY. A copy
of the South Dakota Cosmetology Laws/Rules book is sent after the reciprocity application is received for information and
review by the applicant prior to taking the Laws/Rules exam. The exams are offered in English or Vietnamese. No
interpreters or dictionaries allowed. All applicants must have passed a theory examination given by another state board or
a professional testing company.
☐ 4. EDUCATION REQUIRED. 1,500 hours cosmetology, 600 hours esthetics, 400 hours nail technology. If you transferred
education from one school to another, you will have to state that on the application. See below to add work experience if you
do not meet the education requirements. If you do not have the work experience, then you will need to return to school. We
only accept education documentation from another State Board of Cosmetology. We do not accept education documentation
from the school. All hours need to be earned at the school. Home study or online courses are not accepted.
☐ 5. WORK EXPERIENCE AFFIDAVIT. If you do not have the education as required above in #4, then you may add work
experience to your education. Example: 1,000 education hours + 500 work credit = 1,500 hours for cosmetology. Remember,
2 work hours equal 1 hour of education so you need to work 1,000 hours to get 500 work experience hours. *If the work
experience was obtained more than five years before the date of this application, you will need to attend an Infection
Protection course from the commission. Call the office for the course.
WORK HOURS
________ You may get a maximum of 1,000 hours of cosmetologist experience
________ You may get a maximum of 350 hours of esthetician experience
________ You may get a maximum of 200 hours of nail technician experience
☐ 6. RECIPROCITY FEE OF $100.00. Cashier’s check or money order only (non-refundable). This fee covers any tests, study
materials, the initial license, and verification of documents submitted for reciprocity.
☐ 7. TEMPORARY LICENSE APPLICATION AND LICENSE FEE OF $6.00. Cashier’s check or money order only (non-
refundable). This is processed after the reciprocity application is approved for those who qualify for a temporary license.
YOU CANNOT WORK IN SOUTH DAKOTA UNTIL YOU GET A SOUTH DAKOTA LICENSE
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

SOUTH DAKOTA COSMETOLOGY COMMISSION (South Dakota DLR)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 21 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document